Does allostatic load predict incidental coronary events differently among sexes?

Area of Science:

• Cardiology
• Biomarkers
• Health Outcomes

Background:

• Allostatic load (AL) quantifies physiological dysregulation using multiple biomarkers.
• AL is associated with adverse health outcomes, including cardiovascular diseases and coronary events (C-E).

Purpose of the Study:

• To compare the predictive performance of different allostatic load (AL) scoring methods for coronary events (C-E).
• To investigate sex differences in baseline C-E risk and AL-associated C-E risk.

Main Methods:

• Longitudinal analysis of 4327 participants from the Heinz Nixdorf Recall Study.
• Applied count-based, Z-score, and logistic regression weighting method (LRM) for AL scoring.
• Used Cox regression to predict C-E incidence, with and without covariate adjustment and interaction analysis with sex.

Main Results:

• All AL scoring methods significantly predicted C-E; LRM showed the best initial performance.
• After covariate adjustment, count-based and LRM methods outperformed the Z-score method.
• Interaction analysis revealed a more pronounced effect of AL on C-E for females at higher AL levels.

Conclusions:

• Allostatic load (AL) scores are valuable for predicting coronary events (C-E).
• The count-based AL method is suitable for clinical practice due to its simplicity and performance.
• Females may benefit more from interventions targeting AL due to sex-specific risk interactions.